Original Article
Causes and treatment of intimo-intimal intussusception in endovascular repair of aortic dissecting aneurysms
Tao Zhang, Xuemin Zhang, Wei Li, Xin Jia, Xiangchen Dai, Xiaoming Zhang
Published 2019-02-04
Cite as Chin J Gen Pract, 2019, 18(2): 170-174. DOI: 10.3760/cma.j.issn.1671-7368.2019.02.015
Abstract
ObjectiveTodiscuss the causes and treatment of intimo-intimal intussusception in endovascular repair of aortic dissecting aneurysms.
MethodsThis retrospective study included 7 patients with intimo-intimal intussusception who underwent endovascular repair of aortic dissecting aneurysms from January 2017 to June 2018. There were 5 males and 2 females aged 34 to 64 years (mean 47.1 years), with a clinical course from 8 hours to 3 months. Six cases presented with acute chest pain and 1 had abdominal pain. Preoperative CTA was performed in all patients to confirm the diagnosis. Six patients received thoracic endovascular aortic repair (TEVAR) and 1 receivedfenestration.
ResultsThe endovascular repairs were successful without converting to open surgery in all patients. Pathological classifications were 1 type Ⅰ, 5 type Ⅱ and 1 type Ⅲ. Four patients received another aortic stent at distal segment to cover the intimo-intimal intussusception and 1 patient at proximal site. One patients received another bare stent in the superior mesenteric artery, and 1 case received abdominal aortic stent implantation. Balloon was used in 2 cases to dilate the stenosis of aortic stents. The death occurred in 1 case at 3 days after surgery for metadata object description schema, and 1 patient needed continuous renal dialysis after discharge. The postoperative conditions (from 7 to 21 days) of other patients were normal without paraplegia, bowel necrosis, lower limb ischemia or arterial rupture.
ConclusionsThe results indicate that the intimo-intimal intussusception in endovascular aortic dissecting aneurysms repair is rare and it is a severe complication. Re-endovascular aortic repair is a safe and reliable surgical approachbased on the type in early phase.
Key words:
Aortic dissection; Endovascular repair; Arterial intima; Intussusception
Contributor Information
Tao Zhang
Department of Vascular Surgery, Peking University People′s Hospital, Beijing 100044, China
Xuemin Zhang
Department of Vascular Surgery, Peking University People′s Hospital, Beijing 100044, China
Wei Li
Department of Vascular Surgery, Peking University People′s Hospital, Beijing 100044, China
Xin Jia
Department of Vascular Surgery, Chinese PLA General Hospital, Beijing 100853, China
Xiangchen Dai
Department of Vascular Surgery, General Hospital of Tianjin Medical University, Tianjin 300050, China
Xiaoming Zhang
Department of Vascular Surgery, Peking University People′s Hospital, Beijing 100044, China